Medical marijuana for kids?

KelRN215, BSN, RN · Nov 16, 2014

I've yet to see it prescribed for any of my pediatric oncology patients. I HAVE seen marinol used in kids as young as 5 for nausea/vomiting post chemotherapy.

Smalltimore · Dec 9, 2014

No personal experience, but there is a blog about blog about a young Utah boy who is on the Hemp Extract Registry.

HopefulRN7 · Nov 26, 2015

This is an old thread but in case anyone is searching this topic...here's my experience

I'm a private duty Peds nurse and one of my patients has a high grade glioma tumor (malignant) on her brain stem. Because of the location of the tumor, it is inoperable. Pt was diagnosed at 3-mo and is approaching her 1st birthday next month. Her onc team basically told her family that she would most likely not survive to see her first birthday, arranged for skilled nursing care at home (she has a trach and G-tube). I started nursing services for her at home in June 2015 and she would go inpatient for a week a month for chemotherapy. She would go in for bi-monthly MRI's of the brain and the first two showed tumor progression despite the aggressive chemo treatment. In September 2015, her parents decided to explore alternative treatment. We made the trip to Maine to see a DO who prescribed medical cannabis oil (a combination of CBD and THC at specific levels). We have been administering the oil Q4h at home and she receives Avastin IV and oral chemo every two weeks. A month after starting the medical marijuana her MRI showed that not only did her tumor stop growing, but it actually shrunk and moved off of her brain stem! When I got the good news I immediately started crying not only because I've grown close to this patient and her family but because the therapeutic use of cannabis is very close to my heart- I believe in the medicinal use and have supported it for years and even presented the benefits to my entire class in nursing school. I've received a lot of negative feedback over the years and I attribute that to the stigma that surrounds cannabis as a "street drug". Now that I've gone through this experience personally, I recommend and support it even more. While I know my patient still has an uncertain and rough road ahead of her, the benefits I've seen so play out so far reaffirm my faith- she has been less fussy, has had measurable decreases in N/V post chemo tx, her hair is growing, she will be weaning off of her trach next month, we have started PO formula feeds in hopes of removing her G-tube in the coming months and she has a FANTASTIC quality of life- my days on shift with her consist of lots of big smiles while she jumps around in her bounce-a-roo, hearing her first words and belly laughs, baby snuggles, and teaching her to crawl (she is currently inch-worming it and will be crawling around the house any day now)

This has been my experience with it so far and I feel extremely blessed to see this little girl progress despite the odds stacked against her. The doctors we work with all say that though they obviously support medical marijuana- they can not guarantee it will work in all instances but I say, if it isn't going to harm the patient (there are no harmful side-effects identified as of yet), and the diagnosis is terminal, why not try something a little different that conventional treatment? We haven't found a cure yet because most clinicians are caught up in tradition. I believe that we are onto something with medical marijuana and I hope that more and more families will seek it for their children and more nurses will advocate for it and support it.

vintagemother, BSN, CNA, LVN, RN · Nov 27, 2015

Glios make my heart sad. My young sister had one (grade 4/5) at age 22.

While she obviously was not a "true Peds pt", she was treated by pediatric oncologists because her type of cancer was atypical for a 20 yr old. Avg age of onset, I later found out was 80 ish, I think.

Regarding the medical use of MJ and/or CBD, I am not abreast of all the research, but I think, in cases of terminal tumors, such as GBMs, it is fully acceptable for the pt to use whatever means they desire to to receive either healing or palliative treatment. (As long as they are aware of the side effects/potential adverse outcomes)

PS: my sister survived. [emoji3] it's been over 10 yrs and scans are still clear. She was treated with 2 surgeries, chemo and radiation.

Prayers to your little daughter and to the OPs little patient!

As an aside, during school, I had a pt with a GBM, a much older person who so happened to have been an RN. When she opted for the use of MJ, my instructor was appalled that I said I thought it was her choice and I didn't think we should interfere. My instructor actually said I was unethical as a nurse to not try to put a stop to her MJ use by reporting her to authorities.

I'm not in favor of the fact that so many people partake in the use of MJ for medical/recreational use. But I also feel it's not my business to judge them. And it's certainly not ethical to withhold care from/ judge people who use it who have terminal diagnosis.

My sweet patient passed within a month of my conversation with my clinical instructor. [emoji29] at least she's in peace, now.

HopefulRN7 · Nov 27, 2015

Glios make my heart sad. My young sister had one (grade 4/5) at age 22.
While she obviously was not a "true Peds pt", she was treated by pediatric oncologists because her type of cancer was atypical for a 20 yr old. Avg age of onset, I later found out was 80 ish, I think.
Regarding the medical use of MJ and/or CBD, I am not abreast of all the research, but I think, in cases of terminal tumors, such as GBMs, it is fully acceptable for the pt to use whatever means they desire to to receive either healing or palliative treatment. (As long as they are aware of the side effects/potential adverse outcomes)
PS: my sister survived. [emoji3] it's been over 10 yrs and scans are still clear. She was treated with 2 surgeries, chemo and radiation.
Prayers to your little daughter and to the OPs little patient!
As an aside, during school, I had a pt with a GBM, a much older person who so happened to have been an RN. When she opted for the use of MJ, my instructor was appalled that I said I thought it was her choice and I didn't think we should interfere. My instructor actually said I was unethical as a nurse to not try to put a stop to her MJ use by reporting her to authorities.
I'm not in favor of the fact that so many people partake in the use of MJ for medical/recreational use. But I also feel it's not my business to judge them. And it's certainly not ethical to withhold care from/ judge people who use it who have terminal diagnosis.
My sweet patient passed within a month of my conversation with my clinical instructor. [emoji29] at least she's in peace, now.

I am so happy to hear your sister is a survivor, now that is amazing especially considering that the most aggressive forms typically appear in the younger population. Positive thoughts sent her way for continued clear scans.

Your comment about your nursing instructor stating you were "unethical" to support your patients choice to use "MJ"- was your patient taking it legally as prescribed by a Physician as medical marijuana or was she self-medicating? If the latter, I can somewhat understand why your instructor would have an issue with it- marijuana is used as a medication/treatment and requires a prescription just like other medications. We would certainly educate a patient taking someone else's let's say- hydrocodone without obtaining their own rx. If she was prescribed medical marijuana and it was legal in the state the patient resided in then your instructor needs to review her own ethical standards before "educating" an emerging generation of nursing students.

Also, each state that has approved the medicinal usage of marijuana has particular diagnoses that qualify- not all of them are terminal conditions depending on the state. This brings on a whole new set of "ethics" for nurses as we need to familiarize ourselves with the new laws within the states in which we hold licenses and practice in.

vintagemother, BSN, CNA, LVN, RN · Nov 28, 2015

HopefulRN7: no the pt was not taking pill form. And it was likely not prescribed. However, in my state, it's pretty easy to get a script.

Also, thanks for providing more insight into why the professor may have called my ethics into question.

I was simply focused on the fact that the pt was going to die very soon, and she did, within a few weeks.

HopefulRN7 · Nov 28, 2015

HopefulRN7: no the pt was not taking pill form. And it was likely not prescribed. However, in my state, it's pretty easy to get a script.
Also, thanks for providing more insight into why the professor may have called my ethics into question.
I was simply focused on the fact that the pt was going to die very soon, and she did, within a few weeks.

I probably would have done the same thing considering the situation, whether someone thought it was unethical or not. [emoji4] was just playing "devils advocate"